TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article Concurrent Diagnosis of Sjogren’s Syndrome and Polycthemia Vera: a Rare Co-Existence(2023-12-17) Ünal, Serkan; Kocaer, Sinem BurcuThis case report explores the unprecedented concurrent diagnosis of Sjogren’s syndrome (pSS) and polycythemia vera (PV) in a 62-year-old woman presenting with erythrocytosis, classic pSS symptoms, and a positive JAK2-V617F mutation. While autoimmune diseases and hematological malignancies frequently coexist, the combination of PV and pSS has not been previously documented. Despite recurrent phlebotomies for PV, the patient experienced persistent symptoms and elevated inflammatory markers. The case underscores the complexity of managing rare coexisting conditions, emphasizing the importance of considering a broad spectrum of hematological malignancies in primary SS patients. The patient is currently receiving hydroxyurea and hydroxychloroquine with regular follow-ups, shedding light on the challenges associated with the treatment of such unique clinical scenarios. This report contributes to the medical literature by expanding our understanding of potential associations between autoimmune disorders and hematological malignancies beyond conventional patterns.Article Demir Yükü Artmış Karaciğerde İnce İğne Aspirasyon Sitolojisi (iias) ve Tru-cut Biyopsisi: Deneysel Bir Çalışma(2023-01-02) Adalı, Yasemen; Eroğlu, Hüseyin Avni; Makav, Mustafa; Karayol, Sunay Sibel; Fındık Güvendi, Gülname; Gök, Mustafa; Guvendi, Gulname FindikAmaç: İnce iğne aspirasyon sitolojisi (İİAS) tru-cut biyopsiye göre daha güvenli, basit, hızlı ve uygun maliyetlidir ve hasta uyumu genellikle daha iyidir. Birçok organda kullanılan İİAS’nin karaciğerdeki parankimal hastalıklarda kullanımına ilişkin fazla veri yoktur. Bu nedenle bu çalışmada İİAS’nin demir birikimini ve karaciğer hasarını göstermedeki faydası değerlendirilmiştir. Yöntem: Çalışmada 2 kontrol grubu yer aldı. Çalışma sonunda herhangi bir uygulama yapılmayan bu gruplardan İİAS ve tru-cut biyopsi örnekleri alındı. Yirmi sekiz gün süreyle intraperitoneal demir dekstran (88 mg/kg) verilerek demir yüklenmesi oluşturulduktan sonra çalışma gruplarına İİAS ve tru-cut biyopsi işlemleri de yapıldı. Preparatlarda hepatosit hasarı, enflamasyon ve demir birikimi histopatolojik olarak değerlendirildi. Hepatektomi materyaline göre her iki yöntemin duyarlılığı, özgüllüğü, pozitif ve negatif prediktifliği ve tanısal doğruluğu hesaplandı. Bulgular: Hepatosit hasarında; sensitivite (%60), tanısal doğruluk (%66,7) ve negatif öngörü (%50) tru-cut grubunda anlamlı olarak daha yüksek bulundu. Enflamasyonun değerlendirilmesinde yöntemlerin birbirine üstün olmadığı ve İİAS’nin demir birikiminde %83,3 duyarlılık ve tanısal doğrulukla tru-cut biyopsi oranlarına (%100) neredeyse yaklaştığı görüldü. Sonuç: Demire bağlı karaciğer hasarında altın standart doku incelemesi olmalı, bu nedenle tru-cut biyopsi ilk seçenek olmalıdır. Ancak mevcut çalışma sonuçlarına dayanarak tru-cut biyopsinin kullanılamadığı kanamaya yatkınlık, cerrahi erişimin mümkün olmaması, eşlik eden farklı hastalıkların varlığı ya da hasta oryantasyonu ve kooperasyonunun zayıf olduğu durumlarda İİAS’nin daha invaziv seçeneklere göre tercih edilebileceği önerilmektedir.Article Trafik Kazasına Bağlı Kafa Travması Sonrası Maluliyet Değerlendirme Kuruluna Başvuran Olguların Nöropsikiyatrik Sekeller Açısından İncelenmesi(2023-12-01) Ünaldı, Şeyma Tuğçe; Poyraz, Turan; Bora, İbrahim Emre; Can, İsmail ÖzgürAmaç: Travma, az gelişmiş ve gelişmekte olan ülkelerde, ölümlerin en önemli nedenidir. Beyin, kraniyum ve skalp gibi koruyucu katmanlara sahip olmasına rağmen, çeşitli travmalar sonucu kalıcı nörolojik ve psikiyatrik sekellere neden olacak şekilde hasarlanabilir. Çalışmamızda trafik kazasına bağlı kafa travması sonrası maluliyet açısından değerlendirilmek üzere Dokuz Eylül Üniversitesi Hastanesi Adli Tıp Anabilim Dalı’na başvuran hastaların demografik verilerini değerlendirmeyi, nöropsikiyatrik sekelleri değerlendirme aşamasında objektif veri kriterlerinin gerekli olduğunu vurgulamayı amaçladık. Yöntem: 01.01.2019-31.12.2020 tarihleri arasında anabilim dalımız maluliyet kurulunda değerlendirmesi yapılan kafa travmalı olgular sosyodemografik özellikleri, olaydan sonra gelişen nöropsikiyatrik şikayetleri, nöropsikolojik test sonuçları ve işgöremezlik oranı/süresi açısından incelenmiştir. Bulgular: Çalışma süresinde araştırılan hastalardan 579’unda kafa travması meydana geldiği, 579 hastanın 173’ünde kafa içi yaralanmaya bağlı nöropsikiyatrik sekel olduğu ve buna bağlı iş göremezlik oranı belirlendiği görüldü. Olguların %79,2’sinin erkek, %20,8’inin kadın olduğu, yaş ortalamalarının 29,6±15,6 olduğu gözlendi. Çalışma sonucunda en sık 113 olguda (%65,3) unutkanlık, 60 olguda (%34,6) baş ağrısı, 48 olguda (%27,7) psikiyatrik bulgular saptanmıştır. Sonuç: Çalışma sonucunda kafa travmalarına bağlı gelişen nöropsikiyatrik sekellerin oldukça yaygın ve çeşitli olduğu görülmüştür. Travma sonrası klinik tablonun ve travmanın şiddetinin objektif kriterlerle değerlendirilmesi gerekmektedir. Ayrıntılı muayene, nöropsikolojik test ve radyolojik tetkikler bu tip olguların gözden kaçırılmasını önleyecektir.Article The first uniportal VATS sleeve lobectomy in Türkiye: A case report(2024) Hakkı ULUTAŞ; Gülçek, İlham; Kalkan, Muhammed; Ulutas, HakkıIn recent years, video-assisted thoracic surgery (VATS) has become the gold standard approach in the surgical treatment of early-stage non-small cell lung cancer. Especially in cases of central tumors, sleeve lobectomies that preserve parenchyma and respiratory reserves are performed instead of pneumonectomies by experienced clinics. Here, we present the first case of uniportal VATS right bronchial sleeve upper lobectomy for right main bronchial invasion in Turkey, which was successfully performed in August 2022. A patient diagnosed with laryngeal carcinoma who had been in remission for 5 years complained of a cough. Computed thoracic tomography showed hilar peribronchial thickening and an endobronchial lesion (EBL) extending from the right upper lobe bronchus to the main bronchus, almost completely obstructing the upper lobe bronchus. Bronchoscopy revealed that the right upper lobe entrance was obstructed with EBL, and its distance to the carina was 1.6 cm. Bronchoscopic biopsy revealed squamous cell carcinoma. The thorax was entered through an incision of approximately 3 cm in the right fifth intercostal space. First, the right upper lobe pulmonary arteries and superior pulmonary vein were dissected and cut. The main bronchus was divided until the intermediate bronchus. With the help of an endoscissor, the main and intermediate bronchus were incised with appropriate surgical margins, and the lobectomy material was removed. Both macroscopic appearance and frozen and microscopic main and intermediate bronchus surgical margin tumor negativity were confirmed. One suture was passed through the lateral cartilage from the inside out, and the needle was fixed to the posterior pleura. Membranous and cartilage parts were continuously anastomosed with a double-needle 3/0 prolene suture at 2–3 mm intervals. Pathological evaluation confirmed squamous cell carcinoma with a tumor diameter of 1.7 cm, hilar 1/11 lymph node metastasis, and negative surgical margin. Adhering to oncologic principles, sleeve resections, which are difficult even with the currently known open techniques, can be performed effectively and safely with uniportal VATS in experienced centers.Article Chebyshev Polynomial Solution for the Sir Model of Covid 19(2023-12-31) Özdek, DemetIn this study, we deal with solving numerically initial value problem of a mathematical model of COVID-19 pandemic in Turkey. This model is a SIR model consisting of a nonlinear system of differential equations. In order to solve these equations, a collocation approach based on the Chebyshev polynomials is used. Chebyshev polynomials are orthonormal polynomials and the orthonormality reduces the computation cost of the method as an advantage. Another advantage is that the present method does not require any discretization of the domain. So the method is easy to implement. The main idea of the method is to convert the model to a system of nonlinear algebraic equations. For this we write the approximate solution of the system and its first derivative as the truncated series of Chebyshev polynomials with unknown coefficients in matrix forms and then utilizing the collocation points, the SIR model is converted to a system of the nonlinear equations. The obtained system is solved for the unknown coefficients of the assumed Chebyshev polynomial solution by MATLAB, and so the approximate solution is obtained. In order to check the robustness of the method, residual error of the solution is reviewed. The results show that the method is efficient and accurate.Article Evaluation of Oxidative/Nitrosative Stress Parameters and Histopathological, Immunohistochemical Effects on Cisplatin-Induced Lung Toxicity in Rats(2023-12-01) Yıldız Dalgınlı, Kezban; Öztürkler, Melek; Beşeren, Hatice; Adalı, Yasemen; Atakişi, Onur; Dalgınlı, Kezban YıldızThe main focus of this study is to investigate oxidative/nitrosative stress and antioxidant effects and immunohistochemical effects in cisplatin-induced lung toxicity. In the study, 12 male Sprague Dawley rats, 2 months old, were divided into two groups: control (n=6) and cisplatin (n=6). Isotonic solution was administered to control and cisplatin 10 mg/kg single dose intraperitoneal to cisplatin group. Reducte glutathione (GSH), malondialdehyde (MDA) and nitric oxide (NO) levels were determined by spectrophotometricmethod in the lung tissues taken. Paraffin blocks were made from lung tissues and stained with hematoxylin-eosin (HE) staining. Immunohistochemically, p53, CD3, CD20, Bcl-2 ve Ki67 were evaluated. It was found that cisplatin administration alone had no effect on MDA and GSH values in the lung tissue of rats, and NO levels were significantly increased (P<0.005). In the histopathological evaluation of the lung tissue, congestion-bleeding findings, intense inflammation areas, lymphoid follicles around the bronchi and bronchioles were seen with HE staining. Concentric fibrous and fibrinous plugs consisting of blood-fibrin and inflammatory cells and fibroblasts in the airways were observed, with low- density edema between the alveoli. Reactive pan B cell markers CD20, T-cell marker CD3 in the interstitial component and desmin in sub-epithelial cells were stainedpositively by immunohistochemical staining, while reactive germinal centers Bcl-2 and p53 applied to the bronchioles and alveolarducts were immunohistochemically stained negative. In addition, low-intensity nuclear staining was found with Ki67 immunohistochemical staining.In conclusion, significant increase in NO level and immunohistochemically intense inflammation, lymphoid follicles, fibrous and fibrinous plugs are an expression of the onset of cisplatin-induced lung injury..Article Experimental Intravaginal and Intrauterine Endometritis Model: Which Model Is More Useful?(2022-12-31) Beşeren, Hatice; Makav, Mustafa; Kuru, Mushap; Adalı, Yasemen; Coşkun, Mustafa Reha; Eroğlu, Hüseyin AvniThis study aims to compare the newly created intravaginal endometritis model (IVM) with the intrauterine endometritis model (IUM). E. coli infusion was used as intravaginally for IVM and intrauterinally for IUM model. The animals were exeuted on the 7th day. Histopathological and biochemical analyses [malondialdehyde (MDA), glutathione (GSH), Endocan, Endoglin] were performed. A significant inflammation was determined in IVM and IUM compared to the control. A significant decrease in GSH and a significant increase in MDA and Endoglin were determined in IVM and IUM compared to the control. There was a statistically significant increase in the IUM and a numerical increase in the IVM compared to the control. Endometritis was determined by histopathological and biochemical analyses in both IUM and IVM model. It is suggested that intravaginal administration, which is easier to perform, can be used in experimental endometritis model studies.Article Pathological and Biochemical Investigation of the Effects of L-Carnitine and Gemfibrozil on Peroxisome Proliferator Activated Receptors (ppars) and Lipidosis in Rabbits on a High-Fat Diet(2022-12-31) Erkılıc, Ekin Emre; Çitil, Mehmet; Tunca, Recai; Uzlu, Erdogan; Karapehlivan, Mahmut; Adalı, Yasemen; Yapar, Kürşad; Eroğlu, Huseyin Avni; Makav, MustafaObesity and fatty liver is a worldwide health problem in human with detrimental consequences where many investigations are undertaken to overcome this problem. In this study, gemfibrozil and L-carnitine were evaluated in prevention of obesity and lipidosis. The study involved 56 New-Zealand Albino rabbits, divided into 8 equal groups (n=7). The groups were as follow; group I (normal diet), II (normal diet +gemfibrozil), III (normal diet+L-carnitine) and IV (normal diet+gemfibrozil+L- carnitine), V (high fat diet), VI (high fat diet+gemfibrozil), VII (high fat diet+L- carnitine) and VIII (high fat diet+gemfibrozil+L-carnitine). Animals were blood sampled and wieght weekly during the experiment and at the end of the experiment for determination of biochemical parameters (glucose, total lipid). All rabbits were euthanised for histopathological examination and for distrubition of peroxisome proliferator activated receptors (PPARs) in tissues by immunohystochemistry. Gemfibrozil and L-carnitin treatment in rabbits given high fat diet resulted in statistically significant decrease in total lipid when compared to those only received high fat diet. Beta oxidation of high fat diet group was significantly higher than that of groups additionally received gemfibrozil and L-carnitine. Immunohistochemistry revealed an increase in PPAR, PPAR-α and β but not PPAR-γ expression in high fat diet group. On the contrary, L-carnitin administration had no effect on tissue PPAR expression. PPAR-α expression differed between groups received gemfibrozil and high fat diet and those did not. The most marked macroscopy finding was abdominal fat increase in high fat diet group (group V). On the other hand gemfibrozil administration resulted in significant abdominal fat decrease. Furthermore decreased abdominal fat was marked in gemfibrozil and L-carnitine given animals (group VIII) when compared to other groups. In conclusion, gemfibrozil and L-carnitine administration alleviated abdominal and hepatic fattening. Gemfibrozil also caused a significant increase in PPAR-α expression in the liver. It may be of use in avoiding abdominal fat (obesity) due to high fat diet by use of gemfibrozil, a synthetic PPAR-a ligand, and L-carnitine.Article Citation - Scopus: 1Course of Treatment of Chronic Bleeding and Anemia with Systemic Bevacizumab Treatment in Hereditary Hemorrhagic Telangiectasia: A Retrospective Cohort(Türkiye Klinikleri, 2023) Durak, Emine; Ugur, Mehmet Can; Gediz, FusunAmaç: Kalıtsal hemorajik telenjiyektazi (HHT), anormal anjiyo- geneze neden olan otozomal dominant bir hastal ıktır. Son y ıllarda, özel- likle şiddetli HHT formlarının tedavisi için hedefe yönelik tedavilere olan ilgi artmaktadır. Bu tedavi seçeneklerinden biri de vasküler endotelyal bü- yüme faktörü inhibitörü bevasizumabtır. Bu çalışmanın amacı, HHT tanısı alan hastalarda sistemik bevasizumab kullanımının kronik kanama seyri ve anemi tedavisindeki etkisini ara ştırmaktır. Gereç ve Yöntemler: Bevasi- zumab kullanan hastaların tedavi yanıtı ve yan etkileri retrospektif olarak değerlendirildi. Bulgular: Hastaların yaş ortalaması 51,5 yıl idi. Ortalama tedavi süresi 15,4 (4-25 ay) aydı. Tüm hastalara 2 hafta arayla ilk 4 doz 5 mg/kg intravenöz bevasizumab uygulandı. Bevasizumab idamesi 5 mg/kg dozunda aylık periyotlarla devam etti. Bevasizumab tedavisi ile hemoglo- bin değerlerinde artış, epistaksis şiddet skorunda parenteral demir ve erit- rosit transfüzyon gereksiniminde azalma sağlandı. Gözlenen yan etkiler, 1 hastada alerjik döküntü ve 1 hastada artralji idi. Yan etkiler nedeniyle hiç- bir hastada tedavinin kesilmesi gerekmedi. Sonuç: Bevasizumab, kontrol edilmediği takdirde ölümcül olabilen HHT’de umut verici bir tedavi seçe- neğidir. Bununla birlikte, tedavi protokolleri ve advers olayların yönetimi konusunda global konsensus sağlamak için daha kapsamlı çalışmalara ih- tiyaç vardır.Article Can the Prognosis Be Predicted in Subacute Thyroiditis?(2023-04-28) Saklamaz, Ali; Çiftçi, ÖzcanAim: Subacute thyroiditis (SAT) is a thyroid disease that seriously affects the quality of life for patients caused by acute inflammation of the thyroid gland. Apart from classical acute phase reactants, the values and rates obtained from peripheral blood count (mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)) values are also accepted as practical indicators of systemic inflammation. Our aim in this study is to compare the effects of systemic inflammation markers and the treatments given in the laboratory tests of our patients with a diagnosis of SAT, on the hypothyroid state one year later. Material and Methods: In this study, which was carried out with a retrospective method, 133 patients were included in the study. The medical data of these patients at the time of SAT diagnosis and one year later were analyzed. 37 patients were in the steroid group and 97 patients were in the nonsteroidal anti-inflammatory drug (NSAID) group. Results: The male/female ratio was similar in both groups. Female dominance was observed in both groups in patients diagnosed with SAT. The thyroid tests of the groups, which were hyperthyroid at the beginning and euthyroid one year later, were similar between the groups (p>0.05). Both groups had an increase in acute phase reactants at baseline (erythrocyte sedimentation rate [ESR] and C-reactive protein (CRP) levels) and normalized after treatment. Neutrophil (p0.05) and platelet (p0.05). Conclusion: Inflammation markers and treatments applied in SAT patients did not have a significant effect on the prognosis